Electrical Stimulation in Addition to Passive Exercise Has a Small Effect on Spasticity and Range of Motion in Bedridden Elderly Patients: A Pilot Randomized Crossover Study

Abstract

Purpose: Belt electrode skeletal muscle electrical stimulation (B-SES) can stimulate large portions of muscles including deep sites without localisation of the stimulation area. The purpose of this study is to investigate both immediate treatment effects of B-SES and long-term treatment effects of B-SES with passive exercise on range of motion (ROM) and muscle tone of lower extremities in bedridden elderly patients. Methods: Outcome measures before and after B-SES treatment alone (4 Hz, 20 min, both lower extremities) were examined for the immediate effect. Outcome measures were: ROM and Modified Ashworth scale (MAS) of hip flexion and adduction; knee flexion and extension; and knee joint distance at position of flexion abduction in hip (distance of knee). A randomized crossover trial was conducted to examine the long-term effect of adding B-SES to passive exercise on ROM and MAS. Results and Discussion: The immediate effect study had 18 patients. ROM and MAS of 4 joint angles in 2 joints and distance of knee significantly improved after B-SES treatment. The long-term effect study had 11 patients. Friedman test revealed ROM and MAS of 4 joint angles in 2 joints and distance of knee significantly improved during B-SES intervention but not control intervention. B-SES in addition to passive stretch has a more statistically significant effect on contracture and spasticity in large portions of the lower extremities of bedridden elderly patients than passive stretching alone. Conclusions: We consider B-SES a useful tool to improve the ROM in lower extremities of bedridden patients.